AB0854 Descriptive and retrospective study of different types of spondyloarthritis and referral and diagnosis times
Authors: U. Astigarraga Urkia, N. Del Val del Amo, L. Ibarrola Paino, M. Lopez Gomez, J. Mendizábal Mateos, G. Sada Urmeneta, S. García Pérez, L. Garrido Courel, I. Paniagua Zudaire, R. Gutierrez, L. Horcada, M. C. Fito Manteca
Journal: Annals of the Rheumatic Diseases (2022)

Background Spondyloarthritis (SpA) is a group of inflammatory arthropathies of unknown aetiology that share several clinical, pathophysiological, serological and radiological features. In many cases the initial symptoms are insidious, leading to a delay in diagnosis and initiation of treatment. The time between the onset of symptoms and treatment is of vital importance for the prognosis of the disease. Objectives To describe the clinical characteristics of the SpA cohort, to analyse the number of months from symptom onset to referral to the rheumatology department and diagnosis of SpA, as well as differences according to the referring department. Methods Retrospective descriptive study of patients with a diagnosis of PsA according to the ASAS criteria and CASPAR criteria for the psoriatic arthritis subgroup (PsA), in a single hospital centre. We collected demographic variables separated by subgroups of peripheral and axial SpA and PsA, age at diagnosis, time from symptom onset to referral to the rheumatology department and to diagnosis, as well as differences according to the department making the referral. Results Seventy-five patients with SpA were analysed, 40 had peripheral and axial SpA and 35 (46.66%) PsA. Thirty-six patients (49.3%) were female (Table 1). Patients with peripheral and axial SpA had a higher mean age at diagnosis than patients with PsA. 45.1 years (SD 11.3) was the mean age at diagnosis. 73.6% of patients were referred from primary care (PC), 9.4% from traumatology, 9.4% from rehabilitation (RH), 3.8% from dermatology and 3.8% from the emergency department. The median time from first symptom to referral to rheumatology was 31.4 (SD 57.2), 7.1 (SD 38.5), 21.7 (SD 51.4) months in peripheral and axial SpA, PsA and total respectively (Table 2). The service with the longest time between symptom onset and referral to rheumatology is PC and rehabilitation for all groups. The median time from first symptom to diagnosis was 43.1 (SD 55.1), 34.4 (SD 65.8) and 39.2 (SD 59.7) months for peripheral and axial SpA, PsA and total respectively (Table 2). The time from referral to rheumatology to diagnosis of peripheral and axial SpA was 12.2 (SD 19.4), PsA 17 (SD 39.3) and total 14.3(SD 29.5) months. Table 1. Demographic characteristics and time in months according to type of SpA. Peripheral and axial SpA PsA Total Age at diagnosis 45.1 (SD11.8) 44.9 (SD10.9) 45.1 (SD11.3) Female 20 (51.3%) 16 (47.1%) 36 (49.3%) Hypertension 10 (25.0%) 10 (29.4%) 20 (27.0%) Dyslipidaemia 17 (42.5%) 17 (51.5%) 34 (46.6%) Diabetes mellitus 5 (12.5%) 6 (17.6%) 11 (14.9%) Body Mass Index 27.9 (SD4.4) 30.5 (SD8.4) 29.2 (SD6.7) Cardiovascular disease 5 (12.5%) 2 (5.9%) 7 (9.5%) Cerebrovascular disease 2 (5.0%) 2 (5.9%) 4 (5.4%) Depression 1 (2.5%) 1 (2.9%) 2 (2.7%) Renal insufficiency 1 (2.5%) 1 (3.0%) 2 (2.7%) Liver failure 3 (7.5%) 5 (14.7%) 8 (10.8%) Time in months from 1st symptom to referral 31.4 (SD57.2) 7.1 (SD38.5) 21.7 (SD51.4) 1Primary care 30.9(SD10.9) 7.01(SD34.1) 21.07(SD35.2) 1Traumatology 5 (SD1.25) 5 (SD2.82) 5 (SD1.48) Rehabilitation 36 (SD29.14) 19 27.5 (SD24.75) 7Dermatology 13 (SD1.41) 13 (SD1.41) 3Emergency service 1 1 1 Time from referral to diagnosis 12.2 (SD19.4) 17.0 (SD39.3) 14.3 (SD29.5) Time from 1st symptom to diagnosis 43.1 (SD55.1) 34.4 (SD65.8) 39.2 (SD59.7) Conclusion In our cohort, patients are referred to rheumatology mainly from PC, which in turn is the service with the longest delay, especially in the peripheral and axial SpA group. Patients with PsA take less time to be referred than patients with peripheral and axial SpA. Once referred to rheumatology, peripheral and axial SpA patients take less time to be diagnosed than those in the PsA group. Disclosure of Interests None declared